Axial CT images confirm the presence of centrilobular (centriacinar) emphysema (A) and pulmonary hypertension (B). The lung parenchyma shows lucent spaces of parenchymal destruction interspersed among normal lung tissue best appreciated in the right upper lobe (A). The main pulmonary artery (arrow) measures 3.8 cm (normal <2.9 cm). The pulmonary artery and aorta should be about the same size and in this case the main pulmonary artery is larger than the companion ascending aorta.
